ࡱ> dfc7 bjbjUU .j7|7| l8Nb$%2W%Y%Y%Y%Y%Y%Y%$ ' *)V}%}%%:W%W%P?:,  pn ?RR' %0%1 R)) SLOUGH R.F.C LTD U18 MEMBERSHIP APPLICATION AND PARENTAL CONSENT FORM 2009/2010 Please complete each section in BLOCK CAPITALS and return to the Mini & Junior membership secretary. Please tickNew registrationRe-registrationData AmendmentClub Transfer First Name:Surname:D.O.B.Home Address: Post Code:Male/FemaleHome Tel:Mobile Tel:Email Address:Ethnic Origin(Please tick where appropriate):-White: BritishMixed: White & Black CaribbeanAsian and Asian British: IndianBlack or Black British: CaribbeanWhite: IrishMixed: White & Black AfricanAsian and Asian British: PakistanBlack or Black British: AfricaWhite: OtherMixed: White & AsianAsian and Asian British: BangladeshBlack or Black British: OtherChineseMixed: OtherAsian and Asian British: OtherOther Ethnic GroupPrevious Rugby Club (if any) Representative Playing History (please give dates etc., using a separate sheet if necessary)Playing Position:UnspecifiedFront RowForwardBackPlays at school:YesNoMedical Conditions/allergies (Asthma, Epilepsy, Allergic to penicillin) Please give full details using separate sheet if necessary. Please Note: The medical information given will be kept confidential (Your childs coach will be informed) and will only be used in case of emergency. Name of Parent/Guardian:Address of Parent/Guardian (if different from above): Post Code:Contact Telephone Number:Email Address:School/Education Establishment Name and Address: Contact Number: Post Code:DATA PROTECTION The RFU is fully aware that some people will only want to receive information from the RFU on rugby issues and, therefore, you can ensure that you only receive this type of information by ticking the appropriate boxes below. However, some people will want to receive other information and, therefore, there are three options set out below. If you do or do not wish to receive certain types of data, you should tick the appropriate box below; the RFU may also use such personal data for the following purposes: To send you by electronic mail (including email, SMS or image messages, etc) information about our official sponsors, their associated companies and their products and services which may be of interest to you.Tick here if you do wish to receive such information To send you by electronic mail (including email, SMS or image messages, etc) other information about RFU tickets, products, special offers, opportunities and related service which may be of interest to you e.g. TEL, RFU Travel, The Rugby Store etc.Tick here if you do not wish to receive such information To pass your details to our official sponsors, who may use them now or in the future and to keep you informed by post of their products and services and to compile market research information and statistics e.g. Nike, O2, Ford etc.Tick here if you do not wish to receive such information SLOUGH R.F.C LTD U18 MEMBERSHIP APPLICATION AND PARENTAL CONSENT FORM 2009/2010 I declare that the information on this form is correct. In signing this form I agree that the above named player can be bound by the laws and resolution of the Rugby Football Union and its constituent body and the rules of Slough Rugby Football Club. I consent to the administering of first aid if required. Slough Rugby Football Club may include photographic imagery of the Mini and Juniors in press releases, on the clubs website and other promotional material. In signing this form I agree with my childs image being used. Signed (Parent/Guardian): Date: Print Name:  Type of Membership required Mini and Youth Family Membership - 40 A form will need to be completed by each player. Please return form to: Debbie Lanigan 11,St Andrews Way Cippenham. Slough, Berkshire, SL1 5NH Mob: 07740286979 Email: Lanigan@talktalk.net Cheques made payable to SLOUGH RFC LTD Dear Parent/Guardian, If you are an existing member of Slough Rugby Football Club you will notice that this membership application form has changed significantly. The RFU review us on a regular basis to ensure that we provide an acceptable environment for your child to enjoy rugby (not only through playing but socially as well). This culminates in the club being awarded the RFUs Seal of Approval. Our accreditation is due for renewal in November 2008 and as such we are modifying our processes to comply with RFU requirements. The RFU require us to register membership information online and are also looking for further information to that which we have previously requested. The RFU also request that you submit a passport size photo. Please email all photos to  HYPERLINK "mailto:membership@sloughminirugby.co.uk" membership@sloughminirugby.co.uk. As a club, we will also use the photo on the web for player of the week awards etc. Thanks for your support. Andrew Leighton-Pope Mini & Juniors Chairman P.T.O. Qq%'57EFz|%&(STV '(*FI J c e  ) 9   <=NTbctzvy5 5CJ \ 5CJaJCJaJCJaJ 5CJaJCJaJ 5>*\UPQ$h&#$/If ]^$a$  ^$$Ifl 9% @,H4$                         t 6h$6$$$$44 la%&$If&'56;@55$If$$Iflֈ# [  D%o8A $ t0|)44 la46789:E<$Ifv$$Ifl0D%t" t0|)44 la4EFR\]ij$Ifv$$Ifl0dD% t0|)44 la4jkz{NDHH$If$$IflrD%T  t0|)44 la4{|$Ifv$$Ifl0D%t" t0|)44 la4 2Q$$Iflq0hD%# t|)44 la4$Ifv$$Ifl0hD%# t0|)44 la4$$If$%&'> 88$If$$IflִhT D%                        t|)    44 la4'()67TUwx$Ifx$$Iflq0hD%# t0|)44 la4  $$IflִhT D%                        t0|)    44 la4x$$Iflq0hD%# t0|)44 la4$If  $$IflִhT D%                        t0|)    44 la4>?R0x$$Iflq0hD%# t0|)44 la4$If RS $$IflִhT D%                        t0|)    44 la4STUVstux$$Iflq0hD%# t0|)44 la4$If "#&P$Ifv$$Ifl08D%p ! t0|)44 la4&'()*E F G H I ~v$$Ifl0LD%! t0|)44 la4$IfFf I J c d l$Ifc$$IflD%|) t0|)44 la4d e $Ifv$$Ifl0dD% t0|)44 la4 <$Ifv$$Ifl0dD% t0|)44 la4 $Ifv$$Ifl0dD% t0|)44 la4   $Ifv$$Ifl0,D%d t0|)44 la4    ( $Ifv$$Ifl0dD% t0|)44 la4( ) 9 7 zzc & F P$If^`P$If $$Ifa$v$$Ifl0dD% t0|)44 la4 @ A B $If $If^c$$IflD%|) t0|)44 la4B C <v_ & F P$If^`P$$IflF D%       t0|)    44 la4<=wxy$If $If^c$$IflD%|) t0|)44 la4yzbv_ & F P$If^`P$$IflFxD%       t0|)    44 la4bc$If $If^c$$IflD%|) t0|)44 la4v pp$If$$IflFxD%       t0|)    44 la4(|ztttttttt$If$a$^x$$Iflq0hD%# t0|)44 la4 />P[v^c$$IflD%|) t0|)44 la4$Ify()0JjeU jU\5\5 $^a$^,1h. A!"#$% c$$Ifl8L8 xxd4< !D%                         h            t|)888844 la4DyK !membership@sloughminirugby.co.ukyK hmailto:membership@sloughminirugby.co.ukyX;H,]ą'c i8@8 NormalCJ_HaJmH sH tH <@< Heading 1$$@&a$ 5>*\>> Heading 2$@&^ 5>*\<A@< Default Paragraph Font.U@. Hyperlink >*B*ph,, Header  9r , @", Footer  9r jPQ%&'56789:EFR\]ijkz{|$%&'()67TUwx>?RSTUVstu "#&'()*EFGHIJcde   ()97 @ A B C < = w x y z b c ( />P[v00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 000000 000000 00000000000 000000000000000000000000000000000000000@0 0 y3&6Ej{$'RS&I d  ( B <yb !"#$%&'()*+,-./0124(X8@0(  B S  ? PYHM R 3333<=EO -./uvvyz{laniganlaniganlaniganlaniganOEMlaniganKC:\Documents and Settings\Debbie\My Documents\RUGBY\subs_form_2009-2010.doclaniganKC:\Documents and Settings\Debbie\My Documents\RUGBY\subs_form_2009-2010.doclaniganKC:\Documents and Settings\Debbie\My Documents\RUGBY\subs_form_2009-2010.doc3} 06;qh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hH6;q3}                   %&'5678EFR\]ijkz{|$%&'()67TUwx>?RSTUVu "#&'()*IJcde () @ A B C < = w x y z b c @ w @@UnknownGz Times New Roman5Symbol3& z Arial?5 z Courier New;Wingdings"qh\%٦"sfO"#!20d 3QHSLOUGH RlaniganlaniganOh+'0  0 < H T`hpx SLOUGH R LOUlanigananianiNormallanigan4niMicrosoft Word 9.0@ @RB@1-@d7?O՜.+,D՜.+,4 hp|   o"  SLOUGH R Title 8@ _PID_HLINKSA~(mailto:membership@sloughminirugby.co.uk  !"#$%&'()*+,-./012345789:;<=?@ABCDEFGHIJKLMNOPQRTUVWXYZ\]^_`abeRoot Entry F@ ?gData 61Table>)WordDocument.jSummaryInformation(SDocumentSummaryInformation8[CompObjjObjectPool@ ?@ ?  FMicrosoft Word Document MSWordDocWord.Document.89q